Loss Adjuster

A person who assesses the size or value of a loss on behalf of the Insurer.
***
UK: an independent expert who negotiates claims settlements as an intermediary between the insurer and the insured.
***
UK: Independent claims expert engaged by insurers to investigate claims and assess the true extent and value of any loss. Loss adjusters are not engaged for smaller, routine losses. The relevant professional body is the Chartered Institute of Loss Adjusters.

Loss Adjustment Expense

All expenditure of an insurer associated with its adjustment, recording and settlement of claims, other than claim payment itself. The term encompasses both allocated loss adjustment expenses (ALAE) which are loss adjustment expenses identified by a claim file in the insurer’s records, such as attorney’s fees and unallocated loss adjustment expenses (ULAE) which are operating expenses not identified by claim file, but functionally associated with settling losses, such as salaries of claims department.
***
The total expenses associated with adjusting a claim. The actual amount of the loss is not included in this amount.

Loss adjustment expense (LAE)

US: The cost of investigating and adjusting losses. LAEs need not be allocated to a particular claim. If they are allocated to a particular claim, they are called “allocated loss adjustment expenses” (ALAE); otherwise, they are unallocated loss adjustment expenses (ULAE).
***
UK: The expense incurred by a cedant in the defence and settlement of claims but not its overhead expenses. The definition of LAE depends on the terms of the reinsurance contract.
***
REINSURANCE: The expense incurred by the ceding insurer in the defense, cost containment and settlement of claims under its policies. It is normally broken down into two categories: Allocated (ALAE) and Unallocated (ULAE). ALAE are those expenses that are directly related to (or “allocated” to) a specific claim such as the legal defense of a liability claim. These are typically covered by a reinsurance contract as a component of reinsured ‘loss”. The elements of loss adjustment expenses that are covered by the reinsurance as loss are specified in the terms of the reinsurance agreement and may be treated on a proportional basis (the ALAE is shared by the cedent and reinsurer in the same proportion as they share the indemnity loss) or it may simply be added to the indemnity loss for reinsurance recovery purposes. By contrast, ULAE are claim expenses that are not directly related to a specific claim and are considered part of the ceding insurer’s overhead and cost of doing business. They are not subject to reinsurance recovery as loss, but may be considered in determining a commission to be paid by the reinsurer to the ceding company (ceding commission) to help offset the ceding company’s expenses.

Loss adjustment expenses

All expenditures of an insurer associated with its adjustment, recording, and settlement of claims, other than the claim payment itself. The term encompasses both allocated loss adjustment expenses (ALAE) that are loss adjustment expenses identified by a claim file in the insurer’s records, such as attorney’s fees and unallocated loss adjustment expenses (ULAE), which are operating expenses not identified by claim file, but functionally associated with settling losses, such as salaries of claims department.
***
Expenses incurred to investigate and settle losses.

Loss assessor

A person, sometimes called a public loss assessor, with specialist knowledge, appointed by the insured to assess his claim and negotiate a settlement with the insurer or insurer’s representative, e.g. loss adjuster.
***
See: assessor.